Should You Purchase Dental Insurance?
Affording the dentist can be a big problem for many families. Dental insurance may be a great option to ensure that you and your family always have access to the dental treatment you need.
Dental insurance is simple terms, protects your smile.
With the rising cost of going to the dentist, many people are struggling with the decision of whether or not to purchase dental insurance. Whether you are considering buying dental insurance through your employer or independently, be sure to investigate several different plans and ask questions about several factors, including network policies and coverage types. This information will help you choose the right dental insurance plan before signing on the dotted line.
The yearly maximum is the most money that the dental insurance plan will pay within one full year. The yearly maximum will automatically renew every year. If you have unused benefits, these will not rollover. Most dental insurance companies allow an average yearly maximum of $1,000.
Most independent dental insurance plans will only pay for your dental services if you go to a contracted and participating in-network dentist. Find out if you are required to go to a participating dentist or if you can choose your own. If the plan requires that you see an in-network dentist, ask for a list of the dentists in your area with whom they are contracted so you can decide if they have a dentist you would consider seeing.
If you wish to stay with your current dentist, some policies allow you to see an out-of-network dentist, however, the costs covered may be significantly lowered.
Almost all dental insurance companies use what is called a Usual, Customary, and Reasonable (UCR) fee guide. This means that they set their own price that they will allow for every dental procedure that they cover. This is not based on what a dentist actually charges, but what the dental insurance company wishes to cover. For example, your dentist may charge $78 for a dental cleaning, but your insurance company will only allow $58 because that is the UCR fee that they have set.
If you are on a policy that requires you to go to a participating provider, you should not be charged the difference between these two prices. A contracted dentist generally has an agreement with the insurance company to write off the difference in charges. If the policy allows you to go to a dentist or pediatric dentist of your choice, check the insurance company’s UCR fee guide against the fees that dentist charges. You may be required to pay the difference out of your pocket, however, you cannot put a price tag on quality dental care.
According to most dental insurance companies, dental procedures are broken down into three categories:
- Preventative: Most insurance companies consider routine cleanings and examinations as preventative dental care, however, X-rays, sealants, and fluoride can be deemed as preventative or basic, depending upon the specific insurance carrier.
- Basic or Restorative: Basic or restorative dental treatment usually consists of dental fillings and simple extractions. Some insurance companies consider root canals basic, while others list it as major.
- Major: Crowns, bridges, dentures, partials, surgical extractions, and dental implants are dental procedures that most dental insurance companies consider as a major procedure.
Since all dental insurance carriers vary, it’s important to clarify which dental procedures fall under each specific category. This is important because some insurance plans don’t cover major procedures and others have waiting periods for certain procedures. If you know that you will need major dental work that is not covered by a given plan, you should probably look elsewhere to find one that suits all of your needs.
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